Rescue crews used dogs and flashlights to comb piles of debris that once were homes and businesses in Greensburg, Kansas, today, in a meticulous search for survivors of a killer tornado.
At least eight people died when the twister hit the farming community on Friday night and another was killed in nearby Stafford County.
At least 50 people were injured, some critically, authorities said. A 10th person died and three people were injured on Saturday night when another tornado touched down in southwest Kansas not far from Greensburg.
Authorities searching Greensburg on Sunday said 30 people were rescued from that town's crumbled hospital, and they said it was likely that more survivors, and possibly more victims, would be discovered.
"There is the potential of others still being buried in the rubble, people being trapped in basements," Kansas Emergency Management spokeswoman Sharon Watson said. "The focus is on covering a large area as fast as possible."
Some 90 per cent of the businesses and homes in Greensburg, a town of about 1,800 people, were damaged or destroyed when the mile-wide tornado and winds of 165 mph (265 kph) roared through.
Ms Watson said assessment teams were to start trying to gauge the cost of the damage during the day. Greensburg resident Bruce Foster, 50, said he rode out the storm in the basement of a friend's house, huddling under a mattress with a group of neighbors.
"The house started shaking and dust was falling. Our ears started popping and then it got all calm," Foster said. "We went upstairs and the house was gone, all gone. There wasn't any furniture or anything."
President George W. Bush has declared the community a major disaster area and ordered federal aid to supplement state and local recovery in Kiowa County, where Greensburg is located.
"Our hearts are heavy for the loss of life in Greensburg, Kansas," Mr Bush said after attending church in Washington. "I'm confident this community will be rebuilt."
Kansas Governor Kathleen Sebelius also declared a state of disaster emergency for Kiowa County. In southwestern Kansas residents still struggled to comprehend the losses.